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I have carotid blockages of 100% and 60%. Do I need to worry about PAD and heart disease?

Question:

I have just been diagnosed with carotid blockages of 100% and 60%. Do I need to worry or have more tests for blockages in other areas? Heart cath. or PAD? I have always had yearly physicals with no blockages diagnosed before and this has come as quite a shock.

Answer:

The carotid arteries provide a window through which the cardiovascular system can be viewed. If a person has been diagnosed with carotid artery blockages, this suggests that there is a significant likelihood of accumulation of atherosclerotic plaque in other arteries throughout the body. A person who has carotid artery blockages, as you described, should be checked for atherosclerosis in the lower extremities and in the coronary arteries. Cardiologists will often recommend a cardiac “stress test” for patients who have ultrasound findings of carotid artery blockages. This will help diagnose whether or not there is significant coronary artery disease. If the findings of the stress test suggest that there is significant coronary artery disease, a cardiac catheterization is sometimes indicated to further define the extent of the coronary artery blockages. In summary, although the presence of significant plaque in the carotid arteries does not absolutely indicate that there is significant plaque elsewhere, it certainly should be considered a strong possibility and further testing should be undertaken, in my opinion. With regard to the carotid artery blockages, a 100% blockage of the carotid artery cannot be treated surgically. Once the artery is closed, it cannot be reopened. All efforts should be directed at making certain that the 60% blockage of the carotid artery does not progress further and if it does progress to a critical range (i.e. an 80% or greater blockage), surgical intervention is often recommended. Treatment with statin therapy, dietary modification, and management of hypertension and diabetes should all be important features of the ongoing management of a person with demonstrated atherosclerotic carotid artery disease.